Pregnancy is a time of enormous change, both socially and physically. Socially, pregnancy may limit what you can do and prevent you from having the social support you need; this can cause feelings of loneliness. Additionally, whether your pregnancy was planned or unplanned, whether it is your first baby or your fourth, being a parent to a newborn is a time of change, and this can bring up feelings of overwhelm.
Understanding pregnancy and mental health
Pregnancy is a time of enormous change, both socially and physically. Socially, pregnancy may limit what you can do and prevent you from having the social support you need; this can cause feelings of loneliness. Additionally, whether your pregnancy was planned or unplanned, whether it is your first baby or your fourth, being a parent to a newborn is a time of change, and this can bring up feelings of overwhelm.
Physically, your body is experiencing changes, and you will experience hormonal changes. Mood swings are normal during pregnancy due to these changes, as an increase in oestrogen and progesterone can often exacerbate anxiety. Certain conditions that can occur in pregnancy can also lead to increased fatigue and mental health challenges, such as hyperemesis (severe nausea), pre-eclampsia and gestational diabetes. Additionally, you may not be sleeping as well, which can have an impact on mental health.
Overall, it is evident that the combination of physical, emotional and social changes can be overwhelming during pregnancy; these, amongst other factors, can commonly lead to specific mental health conditions, including depression, anxiety and perinatal mood disorders. 15% of women will experience depression or anxiety during pregnancy, and more in the postnatal period. Antenatal depression occurs in 1 in 10 women and 1 in 20 men, and 21% of pregnant women will experience an antenatal anxiety disorder!
"Support and connection are essential to any friendship; by asking how a friend is doing emotionally during their pregnancy, you can make a profound and positive impact."
Recognising the signs
Whilst these figures are high, early intervention is key in managing difficulties with mental health during pregnancy. First, it can be helpful if you know whether your friend has any pre-existing mental health conditions, as they may then be more prone to developing perinatal anxiety and depression. Key signs to look out for include persistent, generalised anxiety and worry (often around health), irritability, sudden mood swings, withdrawal from social activities and extreme fatigue. Additionally, they may experience panic attacks, intrusive thoughts, suicidal thoughts, having little interest in things they used to enjoy and low mood. More subtle signs to be mindful of can include changes in their eating or sleeping patterns.
Fluctuations in mood and anxiety can be normal in pregnancy; however, when these experiences are prolonged or begin to significantly affect their ability to function occupationally and socially, it may be that they are suffering from a perinatal mental health disorder. Generally, if they been experiencing feelings of anxiety or low mood for more than two weeks, it may be time to talk to someone.
How to approach a friend
Often, expectant or new parents will be heavily focused on the mother’s physical health and baby’s well-being; it is important that we let them know that they need to (and are allowed to!) take care of their mental health and emotional well-being as well. Approaching a friend who may be struggling with their mental health during pregnancy requires sensitivity and understanding. Start by choosing a private and comfortable setting where your friend feels safe to open up. Begin the conversation with empathy and non-judgmental language, expressing your concern for their wellbeing. Listen actively and validate their feelings, acknowledging the challenges they might be facing. You can offer specific examples of what you have noticed, such as changes in their mood or behaviour, to show that you have been paying attention and care about them.
Encourage your friend to consider professional support and reassure them that seeking help is a sign of strength, not weakness. Offer your ongoing care and make sure you follow up with them to see how they are doing, respecting their pace and readiness to talk more. Remember, your friend may appreciate your concern and support more than you know during this vulnerable time.
"15% of women will experience depression or anxiety during pregnancy, and more in the postnatal period."
Supporting your friend
Knowing that a friend is struggling can be difficult, and we can often feel lost and helpless in how best to support them. The best and easiest way to do this is by just being there; ensure your friend knows that you won’t judge them and will be an empathetic ear when they need it. You don’t have to become your friend's psychologist; there are plenty of professional help options for that!
A few helpful ways to show care for a struggling friend can with be practical; assisting them with booking those initial appointments and finding specialists - even going with them to appointments, if they would find it helpful. Helping with cooking, cleaning or shopping so your friend can have some time to focus on themselves can be useful. Additionally, exercise is beneficial for mental health in general and is particularly helpful while pregnant; short walks together with your friend may provide a change of scene, a listening ear and a mood boost that exercise can bring! Finally, limiting exposure to unhelpful social media and online forums. where people share inaccurate, preconceived ideas or unrealistic expectations of pregnancy, is recommended.
The role of professional help
Seeking professional help is paramount in effectively managing mental health issues during pregnancy. Early intervention is key, as antenatal mental health difficulties can often extend into the postnatal period if not managed. Research has found that these conditions can negatively affect postnatal outcomes, with one example being that there are higher odds of the baby having low birth weight and lower gestational age at birth (less than 37 weeks). Additionally, there can be an increased risk of miscarriage and risk of preterm birth (which can have its own impacts, such as developmental delays and learning disorders). After birth, the effects of prenatal stress may also have an impact on the child; some studies have found that children may be more likely to have Attention Deficit/Hyperactivity Disorder (ADHD) or depression. Whilst this may sound scary, professional help is always available, and ensuring your friend feels supported is essential.
The first step in seeking professional help is often to book an appointment with their general practitioner (GP) or obstetrician to discuss options and to help them find a suitable psychologist or mental health professional. They may also suggest suitable psychiatrists and other health providers if needed. Currently, people can access Medicare rebates for mental health support. This can be obtained through a referral and Mental Health Care Plan from the GP. Gidget Foundation Australia offers bulk-billed sessions meaning there is no out-of-pocket cost, for expectant, new and potential parents to access specialist mental health support.
In a crisis or if your friend is feeling suicidal, there are resources for yourself and your friend; contact a 24-hour crisis support line such as Lifeline Australia (13 11 14) or the Mental Health Line (1800 011 511). They can also present to their nearest Emergency Department or call 000. PANDA (Perinatal Anxiety and Depression Australia) also offers a support line (1300 726 306).
"Remember, offering empathetic, non-judgmental support and practical assistance can create a safe space for your friend to navigate these challenges."
Conclusion
In summary, this blog has highlighted the complex challenges of mental health during pregnancy; this time brings immense changes, both physically and emotionally, and it is natural for expectant parents to feel overwhelmed at times. Recognising the signs of mental health difficulties early and encouraging professional help can make a significant difference in their wellbeing. Remember, offering empathetic, non-judgmental support and practical assistance can create a safe space for your friend to navigate these challenges. By standing by them during this vulnerable time, you can ensure they receive the care and support they need to thrive during pregnancy and after.
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